Distribution of blood groups
among blood donors at a tertiary care hospital in Southern Rajasthan
Jain S.1, Agrawal P.2,
Sujanani S.3
1Dr. Suraj Jain, Assistant Professor, 2Dr. Preeti Agrawal, Associate
Professor, 3Dr. Shashi Sujanani, Professor HOD, all authors
are affiliated with Department of Pathology, Pacific Medical College
and Hospital, Bhilo ka Bedla, Udaipur, Rajasthan, India.
Corresponding Author:
Dr. Preeti Agrawal. E-mail: preetibagrawal79@gmail.com
Abstract
Introduction:
Blood grouping is one of the essential aspects of blood transfusion
practice. ABO and Rhesus (Rh) blood groups are the two most important
blood group systems among the various types identified so far.
Distribution of ABO blood group varies indifferent geographical and
ethnic groups. Objectives:
This study was carried out to determine the distribution pattern of
blood groups among blood donors at a tertiary care hospital of Southern
Rajasthan. Methods:
It is a retrospective study covering a period of 3 years from July 2014
to June 2017 that includes 3718 blood donors of which 1297are voluntary
and 2421are replacement blood donors. Data on the ABO and Rh blood
group type of all blood donors was collected and analysed. Result: The most
common ABO blood group type was Group B (36.6%) followed by group O
(32.1%), group A (22.8%) and group AB (8.5%) respectively. The
distribution of Rh(D) blood group type revealed 93.5% as Rh-positive
and 6.5% as Rh-negative. Conclusion:
The most common ABO blood group type in our region (Southern Rajasthan)
is Group B followed by O and A while, AB is the least common type.
Knowledge of the blood group distribution pattern is essential for the
effective delivery of blood banking services.
Keywords:
ABO, Blood group, Rh factor, Distribution, Blood donors, Rajasthan
Manuscript received:
26th March 2018, Reviewed:
4th April 2018
Author Corrected:
10th April 2018, Accepted
for Publication: 18th April 2018
Introduction
Blood group antigens are integrated parts of the red cell membrane and
have different biochemical compositions [1]. As per recent updates,
International Society of Blood Transfusion (ISBT) has described about
35 blood group systems [2]. Among them, ABO and Rhesus (Rh) blood group
systems are most important in clinical practice. ABO blood group system
was the first human blood group system to be discovered by Landsteiner
in 1901[3]. Rh blood group system was later discovered by Landsteiner
and Weiner in 1940. There are 49 antigens in the Rh blood group system
of which D, C, E, c, and e are most common. Presence of D antigen is
termed as Rh-positive, while Rh-negative refers to the absence of the D
antigen [4]. The Rh-negative phenotype occurs in approximately 15% to
17% of Whites but is less frequent in other populations [5]
.Distribution pattern of ABO and Rh blood group systems show variations
in different populations, knowledge of which is essential for effective
management of blood bank inventory [6]. It is therefore important to
know the blood group distribution of any population. The purpose of
this study is to provide data on distribution of ABO and Rh blood
groups in Udaipur and surrounding regions of southern Rajasthan and
also to compare their frequency with data from similar other studies
conducted in other parts of India and elsewhere in the world.
Materials
and Methods
Place of study:
Blood bank attached to Pacific Medical College and Hospital which is a
tertiary level care centre in Udaipur city of Southern Rajasthan.
Type of study:
Retrospective study.
Sampling method: Simple
Random sampling
Inclusion criteria:
All consecutive blood donors over a period of 3 years from July 2014 to
June 2017 involving both voluntary and replacement blood donation
types. Even those who donated blood at camps organised outside by our
blood bank were part of this study. Blood donors included in this study
have fulfilled all the eligibility criteria of a healthy donor (Age
between 18 to 60 years, more than 50 kg weight with haemoglobin more
than 12.5 gm%).
Exclusion criteria: None
Data collection:
Data on gender distribution, type of donation (Voluntary and
Replacement) and blood group type (ABO and Rh) of all blood donors were
collected from the donor registers maintained at the blood bank. Blood
group antigens were determined by test tube method using commercially
available monoclonal antisera.
Statistical method: The
collected data was tabulated and reported in simple numbers and
percentages.
Results
The total number of blood donors registered at our blood bank from July
2014 to June 2017 was 3718 which included 3577 (96.2%) males and
141(3.8%) females (Table 1). According to the blood donation type, 1297
(34.9%) were voluntary blood donors and 2421(65.1%) were replacement
blood donors (Table 2). Analysis of data collected on the ABO and Rh
blood group type of all blood donors revealed Group B (36.6%) as the
most common ABO blood group type, followed by group O (32.1%), group A
(22.8%) and group AB (8.5%) respectively (Table 1). The distribution of
Rh blood group type revealed 93.5% as Rh-positive and 6.5% as
Rh-negative (Table 3).
Table-1: Distribution of
ABO blood group.
|
ABO
Blood group
|
Male
|
Female
|
Total
|
(%)
|
|
A
|
816
|
34
|
850
|
22.8
|
|
B
|
1307
|
55
|
1362
|
36.6
|
|
O
|
1152
|
37
|
1189
|
32.1
|
|
AB
|
302
|
15
|
317
|
8.5
|
|
Total
|
3577
(96.2%)
|
141
(3.8%)
|
3718
|
100
|
The total number of blood donors included in this study was
3718 of which 3577(96.2%) were males and 141(3.8%) were females. The
most common ABO blood group type is Group B (36.6%) followed by group O
(32.1%), group A (22.8%) and group AB (8.5%) respectively.
Table-2: Distribution of
Donor types
|
Donor
type
|
Number
of donors
|
(%)
|
|
Replacement
|
2421
|
65.1
|
|
Voluntary
|
1297
|
34.9
|
|
Total
|
3718
|
100
|
According to the blood donation type, 1297(34.9%) were
voluntary blood donors and 2421(65.1%) were replacement blood donors.
Table-3: Distribution of
Rh blood group
|
Rh
blood group
|
Male
|
Female
|
Total
|
(%)
|
|
Rh-positive
|
3354
|
121
|
3475
|
93.5
|
|
Rh-negative
|
223
|
20
|
243
|
6.5
|
|
Total
|
3577
|
141
|
3718
|
100
|
The distribution of Rh(D) blood group type revealed 93.5% as
Rh-positive and 6.5% as Rh-negative.
Table-4: Comparison of
frequency distribution of ABO and Rh blood groups among different
regions within India
|
Place
of Study
|
A
|
B
|
AB
|
O
|
Rh-positive
|
Rh-negative
|
|
Western
India
|
|
|
|
|
|
|
|
Present
study (Udaipur)
|
22.8
|
36.6
|
8.5
|
32.1
|
93.5
|
6.5
|
|
Udaipur
[8]
|
22.3
|
35.7
|
7.6
|
34.4
|
94.2
|
5.8
|
|
Jodhpur
[6]
|
22.2
|
36.4
|
9.4
|
31.7
|
91.75
|
8.25
|
|
Ahmedabad
[7]
|
21.94
|
39.4
|
7.86
|
30.79
|
95.05
|
4.95
|
|
Vadodara
[9]
|
22.96
|
35.02
|
8.92
|
33.1
|
96.02
|
3.98
|
|
Northern
India
|
|
|
|
|
|
|
|
Jammu
[10]
|
25.6
|
37
|
11.1
|
26.3
|
92.8
|
7.2
|
|
Lucknow
[11]
|
21.73
|
39.84
|
9.33
|
29.1
|
95.71
|
4.29
|
|
Delhi
[12]
|
21.24
|
39.69
|
10.56
|
28.51
|
91.16
|
8.84
|
|
Central
India
|
|
|
|
|
|
|
|
Bhopal
[13]
|
25.63
|
39.25
|
6.5
|
28.63
|
94.88
|
5.12
|
|
Latur
[14]
|
24.9
|
37.98
|
9.47
|
27.65
|
95.19
|
4.81
|
|
Southern
India
|
|
|
|
|
|
|
|
Bangalore
[15]
|
23.85
|
29.95
|
6.37
|
39.82
|
94.2
|
5.8
|
|
Tirupati
[16]
|
20
|
32.2
|
6.1
|
41.7
|
92.8
|
7.2
|
|
Vellore
[17]
|
21.86
|
32.69
|
6.7
|
38.75
|
94.5
|
5.5
|
|
Eastern
India
|
|
|
|
|
|
|
|
Durgapur
[18]
|
23.9
|
33.6
|
7.7
|
34.8
|
94.7
|
5.3
|
|
Assam
[19]
|
24.8
|
32
|
5.55
|
37.65
|
96.86
|
3.14
|
Comparison of frequency distribution of ABO blood group
among different regions within India shows that‘B’
is the most common ABO blood group type in Western, Northern and
Central India while ‘O’ is most common type in
Southern and Eastern India.
Table- 5: Comparison of
frequency distribution of ABO and Rh blood groups among different
regions outside India
|
Place
of Study
|
A
|
B
|
AB
|
O
|
Rh-positive
|
Rh-negative
|
|
USA
[20]
|
37.1
|
12.2
|
4.1
|
46.6
|
85.4
|
14.6
|
|
Britain
[21]
|
42
|
8
|
3
|
47
|
83
|
17
|
|
Australia
[22]
|
39
|
11.4
|
3.5
|
46.1
|
82.1
|
17.9
|
|
Saudi
Arabia [23]
|
33.4
|
6
|
3.8
|
56.8
|
92.8
|
7.2
|
|
Nigeria
[24]
|
23.1
|
21.3
|
2.7
|
52.9
|
97
|
3
|
|
Pakistan
[25]
|
23.3
|
34.1
|
10.4
|
32.2
|
92.2
|
7.8
|
|
Nepal
[26]
|
29.7
|
27
|
8.2
|
35.1
|
97.3
|
2.7
|
Discussion
Blood groups play a vital role in transfusion safety, understanding
genetics, inheritance pattern, and disease susceptibility [7]. The
present study was done to determine the pattern of ABO and Rh blood
group distribution in our region (Southern Rajasthan). Frequencies of
ABO and Rh blood group types of our study areshown in Table 1 and 3.
Comparison of data on ABO and Rh blood group distribution of our study
and similar other studies from different parts of India are depicted in
Table 4. The findings of our study are comparable with the data given
by similar other studies of Rajasthan and other parts of Western
India[6-9].All these studies have described ‘B’ as
the most frequent and ‘AB’ as the least common ABO
blood grouptype. Even similar studies of NorthernIndia [10-12], and
Central India [13,14] on ABO blood group distribution have found
‘B’ blood group as the most prevalent blood type.
On the contrary, similar studies from Southern India [15-17] and
Eastern India [18,19] have found ‘O’as the most
common ABO blood group type followed by B, A and AB which is different
from the findings of our study. Therefore, as seen in Table 4,
‘B’ is the most common ABO blood group type in
Western, Northern and Central India while ‘O’ is
most common type in Southern and EasternIndia. The numbers of female
donors are very less compared to male donors in our study (Table 1).
Similar pattern of gender distribution has been noted by majority of
other Indian studies as well [7,8,10,11,14,15,19]. Low body weight and
anemia are the common reasons for higher deferral rates among females
when it comes to blood donation. Also lack of motivation is another
factor for lesser mobilisation of females towards blood donation.
The frequencies of ABO phenotypes are variable among different ethnic
populations. In whites, the O and A phenotypes are the most common,
while B phenotype is found in approximately 10% of individuals.
However, group B is found twice as frequently in Blacks and Asians as
in whites [20]. The differences in ABO blood group distribution among
various ethnic populations was noted when our study findings were
compared with similar studies in other parts of the world, outside
India as shown in Table 5. ABO group distributionstudies from USA[20],
Britain[21], Australia[22], Saudi Arabia [23]and Nigeria [24].
Documented‘O’ as the most common ABO blood group
type, which is different from the findings of our study. However, only
studies from Southern India[15-17]and Eastern India [18,19] have found
‘O’ as the most common type. In a Pakistani study
[25], the commonest blood group type was ‘B’ which
is same as found in our study, while a study in Nepal [26] found
‘A’ as the most common blood group type,which is
different from the findings of our study(Table 5). Therefore the
distribution of ABO blood group types varies in different geographical
and ethnic groups.
In terms of Rh blood group distribution, the frequency of Rh-positive
is much predominant in our study. This findingis comparable with
theobservations of all other similar studies within India and other
parts of the world (Table 4 and 5). However, the frequency of
Rh-negative blood group was found to be relatively higher (between
15-18%) in USA[20], Britain[21] and Australia [22] as compared to all
other studies from different parts of the world (< 10%)
indicating higher frequencies of Rh-negative blood group in whites.
Conclusion
The most common ABO blood group type seen in this study is Group B
followed by O and A, whereas AB is the least common type. Distribution
pattern of ABO blood group in this region follows the trend seen in
western, northern and central India, but differs from that of southern
and eastern India. Motivational campaigns have to be carried out to
encourage more voluntary blood donations and for higher mobilisation of
females towards blood donation.
Acknowledgements:
I thank my co-authors for their constant support in data collection and
in preparation of this manuscript. I am also thankful to the entire
technical staff of Blood bank attached to Pacific Medical College and
Hospital, Udaipur for their co-operation in compilation of the data
required for this study.
What this study addto
existing knowledge: This study provides data on the blood
group distribution pattern in this region where only limited data is
available on the same. The study also highlights the variations in
patterns of ABO blood group distribution seen in different geographical
areas. The findings of this study can help in creating a database
towards planning and delivery of blood banking services in and around
this region (Southern Rajasthan).
Funding:
Nil, Conflict of
interest: None initiated
Permission from IRB:
Yes
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How to cite this article?
Jain S, Agrawal P, Sujanani S. Distribution of blood groups among blood
donors at a tertiary care hospital in Southern Rajasthan. Trop J Path
Micro 2018;4(2):226-230.doi: 10.17511/jopm.2018.i2.19.